POS0362 SEX-RELATED DIFFERENCES IN CHARACTERISTICS AND MORTALITY OF PATIENTS WITH RHEUMATOID ARTHRITIS AND CONCOMITANT HEART FAILURE
Authors: T. Rudi, V. Zietemann, Y. Meissner, M. Schneider, M. Worsch, A. Strangfeld
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Heart failure (HF) is a common co-morbidity of rheumatoid arthritis (RA) with a high mortality risk [1]. In the general population, significant sex-related differences in HF including aetiology, pathophysiological mechanisms and age are observed, emphasizing the importance to stratify analyses by sex [2] and there is increasing evidence that mortality rates of females are lower, which cannot be explained by comorbidities, HF characteristics or HF medical treatment [3]. <h3>Objectives</h3> To investigate sex specific differences in patient characteristics and their association with mortality in RA patients with concomitant HF. <h3>Methods</h3> RA-patients enrolled and observed in the German biologics register RABBIT between 01/2007 and 04/2022 were selected for the analysis if they presented HF either at enrolment or during follow-up. Observation started at the time of HF reporting (=baseline) and ended at death, dropout or end of follow-up, whichever came first. Baseline patient characteristics were stratified by sex. Cox proportional hazard regression with sex as exposure of interest was applied, adjusted for age (model 1) and further adjusted for comorbidities and RA specific characteristics (model 2). Missing values were imputed once. <h3>Results</h3> Out of 15,917 cohort participants (11,835 females, 74%), 718 patients were identified as prevalent HF cases (473 females, 66%). Females with HF were on average 1.7 years older, had worse physical function and longer RA disease duration compared to males. Females were more likely to have osteoporosis and less likely to have ischemic heart disease (Table 1). 25% of the females and 34% of the males died after a mean follow-up time of 39 and 36 months, respectively. Females had a significant lower risk of death compared to males regardless of adjustment (model 1: HR=0.57 [0.43-0.76]; model 2: HR=0.51 [0.37-0.71], Figure 1). <h3>Conclusion</h3> Our findings demonstrate a longer survival for females compared to males in a cohort of patients with RA and concomitant HF. The difference could not be explained by age, comorbidities and RA-related characteristics at baseline. The observed differences in the clinical profile and mortality highlight the need for research stratifying by sex when investigating cardiac events. <h3>References</h3> [1]PMID: 32378457 [2]PMID: 31544235 [3]PMID: 36386322 <h3>Acknowledgements</h3> RABBIT is currently supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Celltrion, Fresenius Kabi, Galapagos, Hexal, Lilly, MSD, Pfizer, Samsung Bioepis, Sanofi Aventis, VIATRIS SANTE and UCB and previously by Roche. <h3>Disclosure of Interests</h3> Tatjana Rudi: None declared, Vera Zietemann: None declared, Yvette Meissner Speakers bureau: Pfizer, Matthias Schneider Speakers bureau: Astra-Zeneca; Biogen; BMS; GSK; Janssen-Cilag; Lilly; Pfizer; StreamedUp, Consultant of: Abbvie; Astra-Zeneca; Boehringer-Ingelheim; GSK; Lilly; Novartis; Otsuka, Pfizer; UCB, Grant/research support from: Abbvie; AstraZeneca; GSK, Matthias Worsch Speakers bureau: Abbvie, Pfizer, GSK, Galapagos, Berlin Chemie, Novartis, MSD, Anja Strangfeld Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Janssen, Lilly, Pfizer, Roche, Sanofi, UCB. Non-personal, joint grant from a consortium of 14 pharmaceutical companies for the biologics register RABBIT to my institute., Grant/research support from: Non-personal, joint grant from a consortium of 14 pharmaceutical companies for the biologics register RABBIT to my institute.